Appointments, reminders and missed contacts

Appointments are missed for many reasons: reminders may not be understood, the patient forgets, transport or a carer may be unavailable, or the appointment system is hard to use.

Look for patterns

A single missed appointment can have many explanations. Repeated missed appointments, failed call-backs or confusion about dates suggest the current access route is not working for that person.

Reception staff should record any relevant patterns and escalate repeated failures when care could be affected. The aim is to improve safety, not to blame the patient.

Useful checks

• Is the reminder format usable?
• Is a carer or proxy appropriately involved?
• Does the patient need a different appointment time or a written reminder?
• Has the missed care created clinical risk?

Repeated missed appointments may indicate the system needs adjusting, not that the patient does not care.

Where there is uncertainty, record the facts and seek advice rather than making informal arrangements that could breach confidentiality or leave the patient without support.

Match reminder systems to the person. SMS may work for some patients; others need a printed card, carer reminder or telephone contact. Always check consent and authority for contacting others.

Review missed appointments in context. If a person living with dementia repeatedly misses care, consider changing the reminder route, involving a carer, or making a reasonable adjustment.

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